The organization that will be discussed in this paper is the Glendale Adventist Medical Center Psychiatric Institute in Glendale, California. The Institute, a division of the Glendale Adventist Medical Center, is a 60 bed hospital-based inpatient and outpatient facility designed for the diagnosis and treatment of psychological disorders. Glendale Adventist Medical Center itself is a 394 religious based facility, accredited by the Joint Commission for Accreditation of Healthcare Organizations (JCAHO) (Glendale Adventist Medical Center, 2006). Areas of particular specialty include geriatric care, drug and alcohol dependency treatment, and outpatient treatment.
Glendale, California, the community in which this facility exists, is a growing suburb of Los Angeles, with a population of over 200,000 people. Glendale is a site for the area’s film industry. Founded in 1906, the city was one of the first cities formed in California from a land grant of the Mexican government (Columbia Encyclopedia, 2004). Over the years, the city has grown to include suburban shopping areas, public facilities such as parks and the like, and in spite of being an element of the film industry, this Southern California city does not have the pretension or glitz of an area like Beverly Hills, for example.
The population that the Glendale Adventist Medical Center’s Psychiatric Institute serves is diverse from a variety of points of view. First, because of the city’s proximity to Los Angeles, there are a great number of professionals who work in Los Angeles but reside in Glendale. Also, this closeness to a major urban area results in many urban people coming to the Institute for treatment. From a cultural point of view, the diversity that exists in California overall leads to a cultural mosaic of people coming to the Institute for treatment.
The Unmet Need
An unmet need that is certainly valid for the Glendale Adventist Medical Center Psychiatric Unit to pursue is job and/or skills training for persistently mentally ill adults. There is a definite need for this type of a program and service to the community. In terms of vocational rehabilitation services such as job training specifically, studies have identified that this segment of the population is the largest growing segment in need of vocational rehabilitation; further, it has been observed that the occurrence of chronically mentally ill adults is also a growing problem, and these individuals are in serious need of job and skill training in order to allow these individuals to make a contribution to society and to develop a sense of purpose (Hirsch, 1989).
Based on the studies that indicate that there are many chronically ill adults, and the fact that these individuals are in need of job and skill training, the magnitude of this need is clearly seen from several points of view. First, as more adults become mentally ill, and continually find themselves within the grip of some sort of mental illness, the importance of serving these people is critical. Furthermore, as the numbers of these people who desire to continue gainful employment and to contribute their skills to society, the program’s need becomes even more acute.
The consequences of the unmet need are quite frightening. Without proper training for the chronically mentally ill adult, these people will have very little chance of recovery or of leading any semblance of a normal life. If this is allowed to occur, these individuals’ condition could worsen, or beyond this, the mentally ill adults could deteriorate to the point where they become a danger to themselves or others. This makes a compelling argument for making an effort to meet this unfilled need.
At the present time, the Institute does not offer a dedicated vocational rehabilitation program for the chronically mentally ill adult, although elements of such as program may exist within the advocacy or outpatient programs that are currently offered. Other existing policies elsewhere are effective (Bradt, et al, 1993), but as noted earlier, are not numerous enough given the growth of the mentally ill adult population and their demand for skills and job training. The lack of an adequate number of these programs in existence limits the effectiveness of the programs, not through quality, but rather due to quantity. In other words, the programs out there are useful, but there simply are not enough of them.
In all fairness, it should be noted that not all of the programs in existence today are a completely effective success. There are some problems that are common within all of the programs that exist. Often times the stress of returning to the workplace can cause a regression of the patient into a worse state of mind than originally, or the person may simply fail to successfully learn skills and coping mechanisms to be able to return to the workplace. This hardly justifies a wholesale rejection of the programs overall, however.
The existing policies have some very positive outcomes that are also noteworthy. When the chronically mentally ill adult is returned to the workforce, he or she is making a contribution toward their own livelihood and support, thus reducing their burden on other family members or the community at large. By being able to work, these adults are also making a meaningful contribution to society and add to the tax base through the generation of earned taxable wages. It is also arguable that working is a key to the successful rehabilitation of the chronically mentally ill (Goldstein, 1995).
The unmet need, job and skill training for chronically mentally ill adults are evidenced by the existence and scope of the need for such programs. First of all, there is little doubt of the existence of chronically mentally ill adults. Available data indicates that many mental facilities are filled to capacity with those who are viable candidates for job skill and vocational training (Bradt, et al, 1993), and furthermore, among these eligible candidates there is a tremendous desire to obtain the training in order to regain some sense of a normal life and the privilege of contributing to society and their own well being, aiding in their therapy and boosting their self esteem.
Addressing this need is critically important for a variety of reasons as well; by rehabilitating even a portion of the chronically mentally ill adults and return those to the workforce will relieve the financial burden of simply warehousing these people in institutions. The labor market will benefit from the presence of what may be very dedicated and skilled workers who will fill a need for certain types of labor. The more people who work, the less of a burden on society from other points of view such as reduced welfare payments, lower crime rates, and much more. As a final thought, addressing this issue could dramatically reduce the rates of crime and suicide among the population of mentally ill adults.
Bradt, S., Crilly, J., & Timvik, U. (1993). Computer Training for the Young Adult Patient with Chronic Mental Illness. The Journal of Rehabilitation, 59(3), 51+.
Elias, T. D. (1998, April 6). Something to Sell? Try It in Glendale. The Washington Times, p. 2.
Glendale. (2004). In The Columbia Encyclopedia (6th ed.). New York: Columbia University Press.
Glendale Adventist Medical Center.(2006).Retrieved February 10, 2006, from Psychiatric Institute-Glendale Adventist Medical Center Web Site: http://www.glendaleadventist.com
Goldstein, S. B. (1995). Cross-Cultural Psychology as a Curriculum Transformation Resource. Teaching of Psychology, 22(4), 228-232.
Hirsch, S. W. (1989). Meeting the Vocational Needs of Individuals with Psychiatric Disabilities through Supported Employment. The Journal of Rehabilitation, 55(4), 26+.